Yale helps reform Indian HIV care

Two years before University President Richard Levin announced the $75 million Yale-India Initiative in September 2008, the Yale School of Nursing had already decided to train nurses in India and help combat the spread of HIV/AIDS.

The Yale School of Nursing has partnered with the William J. Clinton Foundation and the Indian Nursing Council to create a new curriculum for public health nurses in India who work on HIV/AIDS treatment and prevention. The curriculum, which will launch in spring 2011, will include one-, three- and 12-month continued education programs and a master’s and doctorate program. These programs will help the Indian Institute of Advanced Nursing — a postgraduate nursing education facility being constructed in Chennai, India — advance nursing practices around HIV care and prevention.

The Clinton Foundation first reached out to the Nursing School with a plan to create an institute to train Indian nurses caring for HIV patients in 2006, School of Nursing Dean Margaret Grey NUR ’76 said. School of Nursing research scientist and co-director of the curriculum development project Angelo Alonzo said the institute aims to enhance care for patients with HIV by training nurses to take on a more active role in health care in India.

The School of Nursing joined the project in part because the current structure of health care in India hinders HIV/AIDS treatment, said professor Nancy Reynolds, director of the institute’s curriculum development.

“The workforce in India is not adequate for them to really have the infrastructure they need to effectively prevent and treat HIV,” Reynolds said.

Currently, Indian nurses’ work is mainly clerical, Alonzo said. Though the clinics are often full of patients seeking treatment for HIV/AIDS, the nurses are expected to spend time completing patients’ paperwork, he said.

During one of Reynolds’ trips to India, a nurse complained about not being able to provide the counseling, patient education and “all the things [other] nurses are prepared to do,” she said.

“In India, nursing is not thought of as a highly regarded profession, so we can work to advance nursing there,” Grey said. “But I think the most important outcome is going to be that the institute itself will lead to better care for people with HIV/AIDS in India.”

Distribution of health care facilities is another problem, Alonzo said. Though hospitals and clinics in most countries exist mainly in urban areas, he said, the lack of facilities in rural regions is particularly problematic in India, where, Reynolds said, two-thirds of the population lives in rural settings.

The institute will aim to solve the issue by attracting rural nurses to study at the center who will then apply the lessons in their practice, Alonzo said.

Additionally, Reynolds said, she hopes the institute’s teaching method will fuse the traditional, lecture-based models used in most of the country’s academic settings with a more interactive approach. She and Alonzo plan to host a teaching seminar for the institute’s faculty before classes begin, she said.

Reynolds said she and Alonzo worked closely with nursing educators in India to devise the curriculum for the five postgraduate programs the institute will offer. The one-month-long program will debut in late spring, even before the institute building has been completely constructed, in a nearby facility, Reynolds said.

About 2.4 million people in India have been living with HIV as of 2007.